Walk on in and see the nurse

Deborah Austin

Monday

Jun 30, 2008 at 12:01 AMJun 30, 2008 at 12:57 AM

The Rock River Valley is getting a taste of a national phenomenon — walk-in health clinics inside retail stores — at a time when the once-booming retail clinic industry is slowing and shrinking nationwide.

The Rock River Valley is getting a taste of a national phenomenon — walk-in health clinics inside retail stores — at a time when the once-booming retail clinic industry is slowing and shrinking nationwide.

Take Care Health Systems, a wholly owned subsidiary of Walgreens, has opened two local clinics since May 27 as part of a steady growth that bucks the national trend.

The first local Take Care Health Clinic opened in a Rockford Walgreens. The second opened June 23 in Belvidere. Other stores in Rockford and in Roscoe are slated to open clinics by the end of the year.

Take Care’s walk-in clinics are open seven days a week and staffed by board-certified family nurse practitioners who treat patients 18 months and older for common illnesses such as sore throats and urinary infections. They also administer vaccines, offer sports physicals and are licensed to write prescriptions which can be filled at a pharmacy of the patient’s choice.

Each Take Care clinic has a collaborating physician with whom nurse practitioners can confer by telephone. Cases outside the scope of clinic treatment are referred to physicians, and emergency cases are sent to immediate care clinics or emergency rooms.

Walgreens puts its Take Care clinics in neighborhoods with limited access issues — “where there’s not another clinic right around the corner that’s open the hours we are open” — said Wendy Edwards, Take Care’s lead nurse practitioner for the Rockford area.

“We’re really not in competition with the immediate care clinics. We’re trying to take the burden off them. A patient might go in there and just have a sore throat, when they could be seen by us instead.”

Walk-in retail clinics were hailed a year ago as the latest wave in inexpensive health care for minor ailments, although retailers such as Walgreens and CVS Caremark have been criticized because their clinics rely on nurse practitioners rather than physicians.

A plan to install Medical Mart physician-staffed walk-in clinics at two Rockford-area Kmart stores last November went by the boards when Medical Mart, a privately backed company based in Las Vegas, went out of business.

The demise was part of a larger fallout after aggressive retail clinic growth that mimicked the dot-com boom, said Tom Charland, CEO of Minnesota-based industry research firm Merchant Medicine. “We saw a lot of irrationality, people getting into the retail clinic business thinking if they opened, people would come.”

The number of retail clinics nationwide nearly quadrupled from 202 to 710 in the year between October 2006 and 2007. Then industry growth slowed.

By April 2008, the total had only reached 964. And many of the privately backed retail clinic companies — such as Medical Mart and My Healthy Access which had clinics in some Wal Mart stores — had gone bust.

It was all about the money, Charland said.

“Many of the new operators were getting funding from private investors before they had a business model, so they were burning cash.” Charland said. “The interest of their investors was in making money.”

Retailers such as Walgreens with its Take Care clinics and CVS with its MinuteClinics take a more long-term view, he said.

“The clinic is a destination, so there are new people coming into their stores who wouldn’t be there otherwise,” Charland said. “And about 25 percent of those patients represent new prescription customers. Even if you haven’t hit break-even (with the clinics), you still have this other benefit going on.”

Even industry leader CVS, which has grown aggressively, cut its MinuteClinic locations from 513 in April to 511 by late June and has announced it is scaling back growth plans, according to Merchant Medicine data.

Walgreens grew its Take Care locations from 158 to 183 during that same time, and said in late June it was on track for 400 clinics by year’s end.

Walgreens does not divulge its costs of building a Take Care clinic, but does expect each new clinic to take two or three years to turn a profit, Take Care Health Systems spokeswoman Lauren Tierney said.

“That’s not an unusual time frame,” she said. “When we open a new drugstore, there’s also a typical two- to three-year period before the store turns profitable.”

That long-term approach seems to prevail at the Rockford Take Care clinic as well. It has seen about 50 patients in the month since its opening, an average of one or two a day, Edwards said. “We’re really doing better than expected,” she said.

The clinics advertise and send direct-mail pieces to their surrounding neighborhoods, but most patients come by word-of-mouth, Edwards said.

Take Care started locally with a staff of eight nurse practitioners when it opened its Rockford store. Edwards anticipates raising that total to 12 by mid-July to cover the Rockford and Belvidere locations.

The local clinics also are compiling a growing list of local physicians to whom they can refer patients who need primary care physicians or specialists.

Nurse practitioners for the Rockford clinic have a list of 10 such physicians so far, Edwards said. They are canvassing the Belvidere area to start a similar list, she said.

For more information visit takecarehealth.com and merchantmedicine.com.

Deborah Austin can be reached at (815) 987-1352 or at daustin@rrstar.com

Take Care Health Clinic Q&A
Where are the Take Care Health Clinics in the Rock River Valley?
Inside the Walgreens stores at 3336 11th St., Rockford, and 230 W. Chrysler Drive, Belvidere.

What hours are the clinics open?
8 a.m. to 7:30 p.m. Monday through Friday, and 9 a.m. to 4:30 p.m. Saturday and Sunday

Do I call ahead for an appointment?
No, patients are taken on a walk-in basis.

Do they take insurance?
Take Care clinics in the Rockford area accept insurance with many major companies including Aetna, Blue Cross/Blue Shield, ChoiceCare, Humana, Medicare, Medicaid and others. Information is available at each clinic.

What will it cost me if I don’t have insurance coverage?
A typical visit including an exam costs between $59 and $74. Some tests, such as a $10 pregnancy test, would be in addition to that cost, while others could be included in your visit cost. Sports and camp physicals are a flat $25.

If you are getting a vaccine, typically there is no visit charge. You are charged only for the vaccine.

How do I pay?
With cash, credit card or debit card. Personal checks are not accepted.

Will I see a doctor?
Not at the clinic. Take Care clinics are staffed by nurse practitioners, who have graduate degrees in advanced practice nursing. Nurse practitioners are licensed to provide such services as performing a physical exam, ordering lab tests, diagnosing and treating diseases and writing prescriptions.

The clinics also have a collaborating physician, whom the nurse practitioner can call anytime during clinic hours if he or she needs to collaborate on your case.

What happens when I get there?
You enter your personal information into a touch screen kiosk at the entrance to the clinic. Information entered includes your name, phone number, birth date, the condition for which you want treatment, and whether you prefer to self-pay or submit your costs to an insurance company.

The nurse practitioner greets you, guides you to an exam room and takes your insurance information, medical history and information about emergency contacts and your primary care physician. The information is entered electronically into the clinic’s computer system.

How big are the clinics and what’s there?
The 260-square-foot clinics are located next to the stores’ pharmacies and share a waiting area with the pharmacies. Each clinic has two patient exam rooms with examination tables, sinks, and equipment to take vital signs such as blood pressures and temperature.

What if there’s a waiting line and I’m not feeling well?
Once you have signed in on the kiosk, your place is held in line. If the nurse practitioner sees there will be a wait, he or she may ask for your cell phone number and call you to come back when your turn is getting close.

At this point, the Take Care clinics in the Rock River Valley area are so new that there have not been waiting lines, said Wendy Edwards, Take Care’s lead nurse practitioner for the Rockford area.

The clinics also offer vaccinations such as tetanus, hepatitis B and meningitis.
You can see a more complete list of treated conditions at takecarehealth.com/treat.htm.

How long does a visit usually take?
Visits typically take about 20 minutes.

What if my condition is beyond the scope of what can be treated at the clinic?
If you need to see a physician, you will be referred back to your primary care physician for care. If you don’t have a primary care physician, clinic staff will offer you a list of physicians in the area who are taking new patients.

If your condition is an emergency you will be sent to the nearest urgent care clinic or emergency room, depending on the severity of your situation. If necessary, clinic staff will call 911.

Do I have to get my Take Care prescription filled at Walgreens?
Your prescription can be sent electronically to any pharmacy of your choice. You don’t need to fill it at Walgreens unless you want to.

Can I take records of my clinic visit to my own doctor?
Yes, you can take a record of your Take Care visit with you. It will give your doctor information about your condition and the history of your treatment at the clinic.

What if I go to a Take Care clinic somewhere else, will they have my records?
Your can ask any Take Care Health Clinic throughout the country to access your records electronically.

For more information see takecarehealth.com.

Sources: takecarehealth.com; Wendy Edwards, Take Care’s lead nurse practitioner for the Rockford area; National Institutes of Health.

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